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Molecular prediction of durable remission after first-line fludarabine-cyclophosphamide-rituximab in chronic lymphocytic leukemia.
- Source :
-
Blood [Blood] 2015 Oct 15; Vol. 126 (16), pp. 1921-4. Date of Electronic Publication: 2015 Aug 14. - Publication Year :
- 2015
-
Abstract
- Fludarabine, cyclophosphamide, and rituximab (FCR) has represented a significant treatment advancement in chronic lymphocytic leukemia (CLL). In the new scenario of targeted agents, there is an increasing interest in identifying patients who gain the maximum benefit from FCR. In this observational multicenter retrospective analysis of 404 CLL patients receiving frontline FCR, the combination of three biomarkers that are widely tested before treatment (IGHV mutation status, 11q deletion and 17p deletion; available in 80% of the study cohort) allowed to identify a very low-risk category of patients carrying mutated IGHV genes but neither 11q or 17p deletion that accounted for 28% of all cases. The majority of very low-risk patients (71%) remained free of progression after treatment and their hazard of relapse decreased after 4 years from FCR. The life expectancy of very low-risk patients (91% at 5 years) was superimposable to that observed in the matched normal general population, indicating that neither the disease nor complications of its treatment affected survival in this favorable CLL group. These findings need a prospective validation and may be helpful for the design of clinical trials aimed at comparing FCR to new targeted treatments of CLL, and, possibly, for optimized disease management.<br /> (© 2015 by The American Society of Hematology.)
- Subjects :
- Aged
Cyclophosphamide administration & dosage
Disease-Free Survival
Female
Follow-Up Studies
Humans
Male
Middle Aged
Rituximab administration & dosage
Survival Rate
Vidarabine administration & dosage
Vidarabine analogs & derivatives
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Chromosome Deletion
Chromosomes, Human, Pair 11 genetics
Chromosomes, Human, Pair 17 genetics
Leukemia, Lymphocytic, Chronic, B-Cell drug therapy
Leukemia, Lymphocytic, Chronic, B-Cell genetics
Leukemia, Lymphocytic, Chronic, B-Cell mortality
Smith-Magenis Syndrome
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0020
- Volume :
- 126
- Issue :
- 16
- Database :
- MEDLINE
- Journal :
- Blood
- Publication Type :
- Academic Journal
- Accession number :
- 26276669
- Full Text :
- https://doi.org/10.1182/blood-2015-05-647925